| NPI | 1245103217 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHEKELA DOUGLAS Owner 601-540-5900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2025-09-25 |
| Last Update Date | 2025-09-25 |